Evaluation and analysis of cross-institutional collaboration models for chronic diseases serv-ices:A survey of medical personnel / 中国卫生政策研究

Objectives: To compare the changes in effectiveness of cross-institutional collaboration before and after intervention and non-intervention from medical personnel in order to empirically support promoting cross-institu-tional communication, coordination and cooperation modes for chronic diseases services. Methods: The typical sam-pling and multistage random sampling were used to conduct a questionnaire survey among medical personnel at villa-ges, townships and county levels. The Propensity ( Tendency) Scores were used to match the samples of the baseline and the following year of intervention, and the results were statistically analyzed. Results: After one-year of interven-tion, the county-level hospital doctors manifested higher participation while the sense of identity in work decreased;township medical personnel offered patient-centered provision of chronic disease services at higher level, but they re-ceived limited benefits from training attendance; and village medical institutions benefited a lot from the improved health care services and improved the clinic capability from cross-institutional collaboration on chronic diseases serv-ices. Suggestions: At the level of cross-institutional collaboration model policy development, attention should be paid on the work needs of county-level hospital doctors. It is also necessary to improve incentive mechanism and to work out definite and clear procedures and standards of promotion, establish a sound cross-institutional training mechanism and put knowledge into practice thereby encouraging individual development. For ultimate stand-straight, the roles and responsibilities of multi-level institutions in cross-institutional cooperation should be explored from the perspective of continuous chronic disease services.

Collaboration among health workers in multi-level health institutions from the perspective of health workers:A case study of three counties in Jiangsu province / 中国卫生政策研究

Objectives:This study aims to analyze the current status of the collaboration of medical staff among county,township,and village with comprehensive prevention and control of chronic diseases based on nine dimen-sions of DMIC integrated medical service development model,with a view to providing medical services collaboration on chronic diseases across the organization to provide direction for improvement. Methods:278 health workers sam-pled by the combination of typical sampling and multi-stage random sampling method received a questionnaire and the results were analyzed statistically. Results:According to the findings of this study,village doctors show higher partic-ipation in chronic care collaboration,but they are faced with the aging population and most of them are poorly educat-ed;the multi-institutional collaboration is of low efficiency in practice although it is well accepted by all health work-ers;there is no existing shared health information system among county,township and village. Conclusion:These re-sults suggest that the government should strengthen its leadership and promote primary health care management through medical staff collaboration;initiatives of health workers should be stimulated to promote the continuity of medical serv-ices;the shared health information system should be set up to facilitate the health workers' collaboration.